<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01//EN"
"http://www.w3.org/TR/html4/strict.dtd">
<html>
   <head>
      <title>Rental Application</title>
      <link rel="shortcut icon" href="icon.png" />
      <link rel="stylesheet" media="print" href="rentap-trans-print.css">
      <link rel="stylesheet" media="screen" href="rentap-trans-screen.css">
   </head>
   
   <body>
   <form>
      <table id=rentapheader>
         <tr>
            <td>
               <img src="icon.png" width="40" height="32" /img>
            </td>
            <td>
               <input type="text" id="rentaladdress" value=""/>
               <input type="text" id="rentalcitystzip" value=""/>
            </td>
            <td id=tdrtitle>
               <div id="rtitle">Instructions by Example</div>
            </td>
            <td>
               <label for="authdate" class="smalllabelinput">Applied</label>
               <input type="text" id="authdate" value="" />
               <div style="font: 12px/14px sans-serif; display:inline-block; position: relative; top: -10px;">
               Row:</div> <input type="text" id="rowprint" value="" />
            </td>
            <td>
               <label for="guestdate" class="smalllabelinput">Guest</label>
               <textarea id="guestdate" cols="8" rows="2"></textarea>
            </td>
            <td>
               <label for="rentdate" class="smalllabelinput">Rented</label>
               <textarea id="rentdate" cols="8" rows="2"></textarea>
            </td>
            <td id="headercontrols">
               <div id="google_translate_element"></div><script>
               function googleTranslateElementInit() {
                 new google.translate.TranslateElement({
                   pageLanguage: 'en',
                   autoDisplay: false
                 }, 'google_translate_element');
               }
               </script><script src="//translate.google.com/translate_a/element.js?cb=googleTranslateElementInit"></script>
            </td>
         </tr>
      <table id=rentapbody>
         <tr>
         <td>
            <ul>
               <li class="section_header">
                  <strong>Personal Information</strong>
               </li>
               <li>
                  <label for="fullname" class="personalinfo">Full Name</label>
                  <div id="fullname" class="pi-instructions">My First M Last</div>
               </li>
               <li>
                  <label for="ssnumber" class="personalinfo">Social Security</label>
                  <div id="ssnumber" class="pi-instructions">###-##-####</div>
               </li>
               <li>
                  <label for="birthdate" class="personalinfo"">Birth Date</label>
                  <div id="birthdate" class="pi-instructions">mo/dy/year</div>
               </li>
               <li>
                  <label for="maritalstatus" class="personalinfo">Marital Status</label>
                  <div id="maritalstatus" class="pi-instructions">Single/Divorced/Seperated/Married</div>
               </li>
               <li>
                  <label for="email" class="personalinfo">Email</label>
                  <div id="email" class="pi-instructions">emailname@emailprovider.com</div>
               </li>
               <li>
                  <label for="stateid" class="personalinfo">State ID#</label>
                  <div id="stateid" class="pi-instructions">driver's license/ID# and State</div>
               </li>
               <li>
                  <label for="phone1" class="personalinfo">Phone 1</label>
                  <div id="phone1" class="pi-instructions">555-321-4321</div>
               </li>
               <li>
                  <label for="phone2" class="personalinfo">Phone 2</label>
                  <div id="phone2" class="pi-instructions">555-123-1234</div>
               </li>
               <li>
                  <label for="currentaddress" id="currentaddresslabel"><strong>Current Address, City, State, Zip, Dates, Rent, Landlord name and phone number </strong></label>...
                  <div id="currentaddress" class="instructions">
                     9080 Example Blvd, $200/mo<br>
                     City, ST  Zip<br>
                     Jun'09 - present<br>
                     Mr. Landlord 555-555-5555</div>
               </li>
               <li>
                  <label for="previousaddresses"><strong>Prior Addresses, Cities, States, Zips, Dates, Rents, Landlords </strong></label>...
                  <div id="previousaddresses" class="instructions">
                     7060 Example Ave, $525/mo<br>
                     City, ST  Zip, Aug'08 - Jun'09<br>
                     Mr. Landlord 555-444-4444<p>

                     5040 Example St, Free<br>
                     City, ST  Zip, Jun'08 - July'08<br>
                     Relative/Shelter 555-333-3333<p>

                     3020 Example Rd, $175/wk<br>
                     City, ST  Zip, -Dec'07 - May'08<br>
                     Hotel 555-222-2222</div>
               </li>
            </ul>
         </td>
         <td>
            <ul >
               <li>
                  <label for="occupants"><strong>Proposed Occupants: self+age, other+age </strong></label>...
                  <div id="occupants" class="instructions">
                     My First M Last, age<br>
                     First M Last, age, friend/spouse/relative</div>
               </li>
               <li>
                  <label for="pets"><strong>Proposed Pets</strong></label>
                  <div id="pets" class="instructions">
                     name, age, type of animal & breed, size<p>

                     or N/A</div>
               </li>
               <li>
                  <label for="income"><strong>Income &amp Food Stamps</strong></label>
                  <div id="income" class="instructions">
                     $200/mo Food Stamps and $175 every two weeks from job listed below</div>
               </li>
               <li>
                  <label for="employment-instructions"><strong>Employment: address, job, dates, hours, supervisor name and phone number</strong></label>...
                  <div id="employment-instructions" class="instructions">
                     Company Name<br>
                     Address<br>
                     City, ST  Zip<p>

                     as<p>

                     Position, # hours/wk, under<br>
                     Ms. Supervisor 555-111-1111<br>
                     for # months/years</div>
               </li>
            </ul>
         </td>
         <td>
            <ul>
               <li>
                  <label for="evictions"><strong>Evictions Past 10 Years</strong></label>
                  <div id="evictions" class="instructions">
                     Company or Person that evicted you in Month/Year from Address, City, ST  Zip</div>
               </li> 
               <li>
                  <label for="felonies"><strong>Felonies/Drug Convictions</strong></label>
                  <div id="felonies" class="instructions">
                     Offense, County, State, Date, D.O.C. ID, and, if currently on parole/probation, include P.O. name and phone number.</div>
               </li>
               <li>
                  <label style="position: relative; top: 7px;"><strong>Applicant Authorization</strong></label>
                  <div style="position: relative; top: 7px;">
                     Applicant authorizes the landlord to
                     contact past and present landlords,
                     employers, and any other sources deemed 
                     necessary. All information is true, 
                     accurate, and complete to the best of 
                     applicant's knowledge. 
                     ANY PERSON IS AUTHORIZED TO RELEASE INFORMATION 
                     ABOUT THE UNDERSIGNED
                  </div>
                  <div style="position: relative; top: 36px;">
                     Sign __________________ Date ________
                  </div>
                  <div style="position: relative; top: 70px;">
                     Print ______________________________ 
                  </div>    
               </li>
            </ul>
         </td>
         <td id="controls">
            <ul>
               <li>
                  <strong>Choose Language Above</strong>
               </li>
               <li>
                  <a href="rentap-translate.html" style="font: 12px/14px sans-serif; padding-left:20px">Blank Application</a>
               </li>
               <li>
                  <div style="padding:14px" />
               </li>
               <li>
                  <strong>Printing</strong> Either ctrl-p or File->Print... Scale 89% or experiment. Set <em>Page Setup,
                  Paper Orientation</em> to <strong>Landscape</strong>. Set <em>Options, headers and footers</em> to <strong>blank</strong> and don't ignore scaling.
                  Print page 2.
                  Page 1 will show the Google Translate banner.<p>
                  You can't print in English unless you first translate 
                  to another language to bring up the Google Translate banner, and then use the banner to switch 
                  back to English. If you try to print directly without the Google Translate banner showing, the 
                  printout will be shifted too far up to fit on the page.
               </li>
               <li>
                  <div style="padding:8px" />
               </li>
            </ul>
         </td>
      </tr>
      </table>
   </form>
   </body>
</html>
